| NPI | 1578022844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: NV 24138) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MA 1013676) |
| Enumeration Date | 2019-03-17 |
| Last Update Date | 2023-10-20 |